Premier Foot and Ankle Specialists PA

Primary specialty

Primary Podiatric Medicine PodiatristTaxonomy code 213EP1101X

License

PO-1580 Issued in FL

Legal business name

PREMIER FOOT AND ANKLE SPECIALISTS PA

Doing business as

Premier Foot and Ankle Specialists

Practice address

4120 Woodmere Park Blvd Ste 5
Venice, FL 34293-5373

Phone

(941) 488-0222

Fax

(941) 480-1668

NPI assigned

Aug 4, 2006

Last updated

Sep 16, 2026By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Brielle Lynn Roggow, D.P.M.NPI 1033559612

Title

Owner

Phone

(941) 488-0222

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Premier Foot and Ankle Specialists Doing business as

Medicare fee-for-service enrollment

Enrolled in FL2 enrollments

Enrollment records 2

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Brielle Lynn Roggow, D.P.M.

  • Podiatrist
  • Venice, FL
  • NPI 1033559612
  Medicare reassignment Care Compare group NPD Authorized official
• Jeremy Bonjorno, D.P.M.

  • Foot & Ankle Surgery Podiatrist
  • Venice, FL
  • NPI 1053795237
  Medicare reassignment Care Compare group NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1154649600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1789516800000",
    "number": "1710995733",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4120 WOODMERE PARK BLVD STE 5",
            "city": "VENICE",
            "state": "FL",
            "postal_code": "342935373",
            "telephone_number": "941-488-0222",
            "fax_number": "941-480-1668"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4120 WOODMERE PARK BLVD STE 5",
            "city": "VENICE",
            "state": "FL",
            "postal_code": "342935373",
            "telephone_number": "941-488-0222",
            "fax_number": "941-480-1668"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PREMIER FOOT AND ANKLE SPECIALISTS PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-04",
        "last_updated": "2026-09-16",
        "certification_date": "2026-09-16",
        "status": "A",
        "authorized_official_last_name": "ROGGOW",
        "authorized_official_first_name": "BRIELLE",
        "authorized_official_middle_name": "LYNN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "941-488-0222",
        "authorized_official_credential": "D.P.M."
    },
    "taxonomies": [
        {
            "code": "213EP1101X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist, Primary Podiatric Medicine",
            "state": "FL",
            "license": "PO-1580",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "041248100",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP BCBS",
            "identifier": "74640",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Premier Foot and Ankle Specialists",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Primary Podiatric Medicine Podiatrist in Venice, FL
• Providers in Venice, FL by specialty
• Primary Podiatric Medicine Podiatrist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.